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s ' <br /> l <br /> P'ASCO COUNTY, FLORIDA <br /> _ Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name S,Lt Control#' <br /> County Parcel No. 22-;' = b J( -, b SubDly:Address/Location 3,0-6 2 by- <br /> Ciassificationti"ype of Use <br /> 2 It- <br /> TRANSPORTATION IMPACT FEE . Rate: Sq.Ft Unit: <br /> Exempt ❑Yes [] No How Determined <br /> Impact Fee Amount $.. 3 2 CX� Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ -- r O <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [1 Yes ..❑No How Determined <br /> PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ <br /> Exempt Yes ❑ No How Determined` <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount/ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By �� Checked By <br /> � — <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE-OF PASCO COUNTY <br /> AcknRwledgement below does not Imply acceptance of concurrence,but simply recelpt of-a copy of this form,placing the building permit owner,on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />